Exercising with arthritis?

The first thing to remember is that ‘Exercise is beneficial for people with arthritis’. Arthritis is a very general term which covers a multitude of conditions which affect joints and is frequently (but not always) linked to the body’s aging process.

If you have arthritis follow these simple guidelines to get the most benefit from your exercise:

Make sure your warmup is slow and gentle warm up with movement to mobilise your joints encouraging the release of synovial fluid to lubricate the whole joint more effectively. It’s a bit like warming oil in a pan so it coats the whole pan surface.

Choose low impact activities to reduce the stress placed on the joint. Pilates, yoga, walking and swimming are all good.

Include strength training as studies have suggested it can decrease pain. It also works to build bone density which encourages healthy joints. Simple exercises standing up can help build strength so don’t choose classes which are all mat based.

Try to maintain the range of movement and flexibility of a joint. You may not become more flexible but should be able to maintain the movement range that you currently have. (Without regular exercise you will gradually have less range of movement.)

Don’t exercise if you have rheumatoid arthritis and your joints feel warm and swollen. This is an indication of flare up and exercise at this time could worsen your condition.

I have arthritis, should I exercise?

About 70% of people over the age of 65 will have some level of arthritis and 1 in 5 of the whole population. This equates to around 10 million people in the UK.

A number of people will have no symptoms and be oblivious to the fact that they have arthritis, but most people with it will suffer some symptoms, such as pain and stiffness, on a daily basis.

The most common type of arthritis is Osteoarthritis, followed by Rheumatoid (especially in women) and Gout (especially in men).

There are actually over 100 different diseases that can cause the problems characterised as arthritis.

There is no cure for arthritis.

What is arthritis?Arthritis affects the joints of the body. At least two bones meet to form a joint, but some joints have three and wrists and ankles have more. Each joint in the body is constructed in a slightly different way. Most of the main joints have cartilage covering the bone ends and the whole joint is enclosed in a sort of bag called the joint capsule. This bag holds synovial fluid which effectively lubricates the joint.Arthritis develops when the cartilage has become worn, torn, or has been removed, often due to trauma.The synovial fluid within the joint capsule becomes thicker or ‘stickier’ as we age and as a result doesn’t coat the cartilage as well. This results in increased wear to the cartilage and the bone ends which become roughened. The joint can no longer slide smoothly and pain results. This is typical in osteoarthritis of the knees, shoulders and hips.With Rheumatoid arthritis joints become swollen as the body attacks its own tissues. There are many other forms of arthritis, such as spondylitis which is when inflammation around the spine causes pain.

What causes arthritis?Arthritis has a variety of causes, most of which are not fully understood. For example:

Trauma to a joint earlier in life frequently makes arthritis more likely. A car accident, sporting injury, trip or fall can all cause damage to a joint, weakening it and making it susceptible to arthritis, sometimes not manifested until later life.

Cartilage has a poor blood supply which means that when damaged by twisting or tearing is doesn’t heal very well. As a result, it was common for cartilage to be removed following trauma, although nowadays this is less frequently performed and exercise is used to manage the situation.

Carrying excess weight puts more strain on the joints increasing the amount of wear and tear.

There is a clear genetic link which can increase the risk factor for Rheumatoid arthritis which can be activated by trauma.

Exercising with arthritis.Arthritis causes joints to be stiff, painful and to have a reduced range of movement. Exercise can improve these symptoms but it needs to take account of the arthritis. I work to create an environment and exercises within which the joints can be moved freely and without pain and you feel able to exercise within you own capabilities. In addition, exercise can encourage good posture, which is essential in keeping the spine straight and reducing the risk of kyphosis – rounding of the neck shoulders as well as potentially slowing the progress of degeneration.

Key points to remember:

Loosening joints, using movement which is pain free, is essential to encourage and keep the maximum mobility. For example, in ball and socket joints, simply rotating the limb within the joint capsule can have a beneficial effect, by encouraging the synovial fluid to coat the whole joint and become less ‘sticky’.

Specific muscle strengthening work to support the damaged joints will help reduce pain on a daily basis. This is especially beneficial for the hips, shoulders, knees and spine.

Do not push through the pain, look for a different way to loosen or strengthen the painful area.

Avoid overstretching and putting joints into positions out of their normal range. For example, knees are a hinge joint, designed to bend in a forward and backward motion with limited rotational range. Sitting with legs crossed will stress the joint and in time can cause wear and then damage.

Note which activities cause pain and look to find other ways of doing them. Exercise can be designed to help you strengthen your body enabling you to do regular activities with less pain.

Finally:Arthritis can be debilitating and has no cure, but exercise is one of the recommended treatments - don’t let arthritis be a reason to stop exercising.

Why do you need strong 'glutes'?

When new people join a class or come to me with back pain they are usually completely unaware of their glute muscles. The glutes are quite likely to be weak and tight, which sounds like an odd combination.

Strengthening the muscle and stretching it so it can function correctly is an essential part of keeping your body working effectively and without pain.

Keeping correct alignmentStrong glutes can protect you from injury and reduce the impact of arthritic pain by providing support to the spine and pelvis. They also give correct alignment throughout the body helping to protect the knees from uneven wear, keep the feet lined up reducing problems with the achilles and plantar fascia.

Support when walking or running or weight trainingThe glute muscles stabilise your pelvis while you run or walk. They help with hip extension and forward propulsion. If they fail to engage correctly the work falls to the hip flexors which are less able and become tight quickly. This puts stress onto the lumbar spine giving back pain. Strong glutes help give correct positioning when weight training, especially during squats, so your knees are protected. They also help with protecting your back when bending to pick up items from the floor or gardening.

Injury preventionIf your glutes are not strong, your entire lower body alignment may become out of balance causing injuries such as achilles tendinitis, shin splints, knee pain and leading to tight ITB which runners are particularly susceptible to. When the glutes are not strong enough to do their job, other muscles not as well designed for the job take over. While in everyday life it is usually the back which suffers, in those who train at a higher level the muscle imbalance is more pronounced leading to increased risk of injury.

StrengthThe glutes are one of the largest muscle groups in the body. If trained it can produce an enormous amount of power. By strengthening this muscle you will be able to move with less stress on your skeletal structure. This is of enormous benefit as bones become less strong with age and affected by degenerative conditions.

Reduction in back painTo simplify the effect strong glutes have on back pain visualise your spine. It runs from the back of your head to your pelvis (hip bones). Your pelvis sits like a t junction at the bottom of your spine. Below this are your glutes, providing support to everything above it – hips and spine. Once you move they are powering from behind you enabling you to move easily with less effort. The other muscle groups, abdominals, quads and hip flexors are at the front of your body and while they are essential for movement and stability they are not nearly so well placed to provide power as the glutes.

Exercise Prescription

EXERCISE CORRECTLYHave you been to a physio recently? Or have you seen an Osteopath?Do you have exercises to do at home?Are you doing them correctly and gaining maximum benefit?Most people do not exercise correctly and so do not get the full benefit!I recently received some training from an experienced osteopath. He suggested that many people given exercises, by physios or osteopaths, don't do them correctly. They don't exercise often enough or for long enough, and they use poor technique. This results in a longer period of pain, more visits to specialists and often no answer at the end of it.The most effective way to exercise a specific muscle is with supervision by a professional, who understands your condition and the exercise required to improve it. Anne at the Studio is one of these professionals.This is where one to one sessions are ideal, allowing you the time with this specialist to talk through and practise the exercises you need to do on a daily or weekly basis.I have listed a few specific issues that would benefit from correct exercise.ArthritisExercise can be hugely beneficial for arthritic joints provided it is carefully monitored. Mobility and strength work must be within your normal range of movement. Back Pain90% of back pain is described as 'non specific' as there is no specific cause and no medical treatment can be offered other than pain relief. Exercise can help manage and considerably reduce levels of pain.Knee PainKnee pain has a variety of causes including injury and degeneration. Exercise can strengthen the joint to give better stability for excellent long term results.